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In the United States alone, the annual direct medical costs associated with RA are estimated to exceed $19 billion, with indirect costs such as lost productivity further amplifying the economic impact 5

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An in vitro study indicates that agomelatine can suppress the upregulation of AT1R expression in HUVECs and the human monocytic leukemia cell line THP-1 cells, and reduce the adhesion of monocytes to ECs, a process involved in the early stages of atherosclerosis

However, this hypothesis is based on experimental studies and cross-species comparative data, and direct causal evidence in humans remains limited

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